title: Contrast-enhanced ultrasonography to diagnose gallbladder perforation.
abstract: OBJECTIVE
  The purpose of this study was to evaluate contrast-enhanced ultrasonography (CEUS) as a modality for diagnosing perforation of the gallbladder (GB) and pericholecystic hepatic abscess.
  
  
  METHODS
  This retrospective study comprised 6 patients with acute cholecystitis and GB perforation plus pericholecystic hepatic abscess who underwent conventional US and CEUS imaging. The following sonographic features were examined: GB contour, defect in the GB wall, and pericholecystic hepatic mass. The findings of conventional US and CEUS were compared.
  
  
  RESULTS
  Conventional US revealed a defect in the GB wall in 2 patients and partially obscured GB wall in 4 patients. Pericholecystic masses were visualized as isohypoechoic masses in 3 and mixed cystic-solid masses in 3 patients. Contrast-enhanced US revealed hyperenhancement of the GB wall during the early arterial phase, and a defect was seen in every patient. The pericholecystic masses showed heterogeneous enhancement with a honeycomb-like appearance during the arterial phase-interpreted abscesses.
  
  
  CONCLUSIONS
  Contrast-enhanced US clearly visualized defects in the GB wall and pericholecystic abscesses in patients with GB perforation. The results indicate that CEUS is a useful modality for the diagnosis of GB perforation.
authors.affiliation: Department of Ultrasound, Shengjing hospital of China Medical University, Shenyang 110004, China. tangss@sj-hospital.org
authors.forename: Shaoshan
authors.initials: S
authors.lastname: Tang
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.forename: Yijiao
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D002764:Cholecystitis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D003287:Contrast Media; D004636:Emergency Service, Hospital; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008100:Liver Abscess / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media